title: The effects of long term fasting in Ramadan on glucose regulation in type 2 diabetes mellitus.
abstract: BACKGROUND
  For Ramadan fasting, observing Muslims do not eat or drink between sunrise and sunset during Ramadan, Islam's holy month of the year according to the lunar calendar. In 2011, fasting patients with diabetes fasted for an average of 16.5 hours per day, having 2 meals between sunset and sunrise for a month. We aimed to evaluate the impact of extended fasting on glucose regulation and observe possible complications of extended fasting in type 2 diabetes mellitus patients.
  
  
  METHODS
  We conducted a randomized, retrospective, observational study. Patients who presented at the Diabetes Clinic during the 15 days before and after Ramadan in August 2011 Istanbul, whose hemoglobin A1c, fasting plasma glucose, postprandial plasma glucose, weight and height value examinations and follow-up were completed were included in the study.
  
  
  RESULTS
  Seventy-six diabetes patients who fasted during Ramadan (fasting group) and 71 patients with diabetes who did not fast (non-fasting group) were included in the study. These two groups with similar demographic characteristics were compared before and after Ramadan. HbA1c, fasting and postprandial plasma glucose, body mass index, weight and adverse events were evaluated. No statistically significant difference was observed among the fasting and the non-fasting groups. There was no difference between the pre and post-Ramadan values of the fasting group.
  
  
  CONCLUSIONS
  We could not find any negative effects of extended fasting on glucose regulation of patients with diabetes who are using certain medications. No serious adverse event was observed. We failed to demonstrate benefits of increasing the number of meals in patients with diabetes.
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey. ckaratoprak@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Karatoprak
authors.forename: S
authors.initials: S
authors.lastname: Yolbas
authors.forename: M
authors.initials: M
authors.lastname: Cakirca
authors.forename: A
authors.initials: A
authors.lastname: Cinar
authors.forename: M
authors.initials: M
authors.lastname: Zorlu
authors.forename: M
authors.initials: M
authors.lastname: Kiskac
authors.forename: M A
authors.initials: MA
authors.lastname: Cikrikcioglu
authors.forename: R
authors.initials: R
authors.lastname: Erkoc
authors.forename: E
authors.initials: E
authors.lastname: Tasan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005215:Fasting / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007514:Islam; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human